5 Reasons to Get Fired Up About Black Maternal & Infant Health

Black women and infants in the United States still experience disproportionately high rates of poor health outcomes and mortality. They are more likely to experience barriers to obtaining quality health care, which is unacceptable. As a Black woman, new mom, and public health nurse, I am joining the fight! So here it is... let's get fired up!

1. The Number of Black Women & Infants Dying During Childbirth.

America is facing a maternal health crisis. This fact is especially true among Black mothers, who are up to four times more likely to die from preventable pregnancy-related complications regardless of their education or income level. To put some numbers behind this, the CDC estimates 700 women in the U.S. will die in childbirth each year, and most will be Black women. The rates are just as staggering when it comes to the rate of mortality in Black infants. Black infants are twice as likely to die from preventable complications during childbirth than white infants. The worse part about these outrageous statistics is that they are nothing new. Black women and infants have been persistently experiencing higher mortality rates and poor health outcomes for the last 50 years.

2. Complications are More Likely to Occur in Black Women.

According to the CDC, 50,000 women will experience a severe life-threatening complication; most will be Black women. Black women are more likely to suffer from pre-existing health conditions like fibroids. Fibroids develop at a younger age and grow faster in Black women, leading to severe complications throughout their pregnancy. Pregnancy-related complications, such as pre-eclampsia and eclampsia, one of the leading causes of maternal death, are 60% more likely to occur in Black women and can be more severe. Black infants top the charts regarding the leading causes of infant mortality, low birth weight, congenital malformations, maternal complications, sudden infant death syndrome, and accidental incidents. Several factors contribute to these statistics, but they all boil down to systemic racism, implicit bias, and poor access to reproductive care.

3. Black Women Experience Implicit Bias

In the cultural section of my health assessment nursing textbook, the author stated Black women have a higher pain tolerance. The author also writes that Black women are more likely to become upset during routine visits. This implicit bias was taught in a Black school to mostly Black students in 2015 and accepted as "things to know about Black female patients." The Center for Cultural Competence at Georgetown University explains implicit bias is dangerous because it can affect a person or their behavior without their full awareness. Implicit bias can interfere with and compromise clinical assessment, decision-making, and provider-patient relationships. Implicit bias is why many Black women are left unheard while raising concerns or expressing pain in a patient-provider relationship. It can also explain why many are scared even to speak up; fears of being labeled the "aggressive Black women" are real! This type of bias is also the reason for more Black maternal deaths. Of course, when pregnant women are ignored, their infant also suffers.

Story-time, one night while working as a bedside nurse in the pediatric cardiac intensive care unit, I was partnered with an older white nurse. As partners, we watched each other's patients if one of us needed to step away or help with anything inside the room. My partner called me in to help change her patient's bed. Her patient was a black female newborn born with multiple holes in her heart. While helping her clean up the baby, the nurse decided it was appropriate to reminisce about her younger days working in a pediatric ICU at a different hospital. After several stories, she told me she was not worried about this little girl's life because "Black female babies are impossible to kill." Shocked, I decided to listen before providing my opinion to her. She told me she and her fellow nurses have tried, and "it's virtually impossible; the Black ones just don't die."

Now, this was more of an example of explicit bias. Years later, this conversation still resonates with me and is one of the driving factors behind my passion for protecting Black women and infants. It is heartbreaking that a newborn baby, fighting for her life, would have to experience such racism.

4. Access to Quality Reproductive Care is lacking for Black Women.

Access to reproductive care is essential to ensure a healthy pregnancy through education, screening, and counseling. However, Black women routinely receive a lower quality of care during family planning, pregnancy, & delivery. 75% of Black women give birth at hospitals that serve predominately Black patients. Hospitals in Black communities have a history of having higher rates of maternal complications and deaths and rank lower on 12 of 15 birth outcomes. Black women are also less likely to have access to quality family planning services leading to more unplanned pregnancies resulting in delayed or no prenatal care. There is a list of systemic reasons black women have reduced access to quality reproductive care. These include maternal age of conception, lack of transportation, and the inability to miss work to appointments. Black infants are twice as likely to be born to mothers who receive little to no prenatal care, placing them at significant risk of poor health outcomes.

5. The Fight Has Started

Although Black maternal and infant mortality rates in the U.S. are a national public health crisis, the work to make changes has begun. On April 13, 2021, President Biden proclaimed April 11 through April 17, 2021, as Black Maternal Health Week.

The President called upon all Americans to "raise awareness of the state of Black maternal health in the United States by understanding the consequences of systemic discrimination, recognizing the scope of this problem and the need for urgent solutions, amplifying the voices and experiences of Black women, families, and communities, and committing to building a world in which Black women do not have to fear for their safety, their wellbeing, their dignity, and their lives before, during, and after pregnancy."

Several organizations and policymakers are currently making strides in creating awareness and systemic policy changes within the healthcare system necessary to positively affect Black women and infants.

Advocate for Yourself!

While large-scale change is ultimately the answer, there are steps Black women can take when receiving care to protect themselves.

• Speak up when you feel something is not correct. If you have a concern, need a deeper explanation, or have questions, make your voice heard!

• Know the signs and symptoms of major pregnancy-related complications and seek care immediately if you experience any of them.

• Record interactions with your healthcare team, especially if your provider did not hear your concerns.

• Continue to seek care postpartum. In the first year after delivery, it is still essential for mom and baby to be seen by a healthcare provider.